敏感性头皮的病因与发病机制

doi:10.35541/cjd.20240301

中华皮肤科杂志 ›› 2025, e20240301.doi: 10.35541/cjd.20240301

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敏感性头皮的病因与发病机制

张蓓蕾¹,宋秀祖²

¹浙江中医药大学附属杭州第三医院，杭州 310009；²杭州市第三人民医院皮肤科，杭州 310009

收稿日期:2024-06-04 修回日期:2024-09-24 发布日期:2025-02-08
通讯作者: 宋秀祖 E-mail:songxiuzu@sina.com
基金资助:
国家自然科学基金（82473549）；浙江省中医药管理局科技计划项目（重大项目）（GZY-ZJ-KJ-23035）；杭州市卫生科技计划重大项目（Z20220040）

Etiology and pathogenesis of sensitive scalp

Zhang Beilei¹, Song Xiuzu²

¹Hangzhou Third Hospital Affiliated to Zhejiang Chinese Medical University, Hangzhou 310009, China; ²Department of Dermatology, the Third People's Hospital of Hangzhou, Hangzhou 310009, China

Received:2024-06-04 Revised:2024-09-24 Published:2025-02-08
Contact: Song Xiuzu E-mail:songxiuzu@sina.com
Supported by:
National Natural Science Foundation of China （82473549）; Science and Technology Major Project of Zhejiang Province and the State Administration of Traditional Chinese Medicine （GZY-ZJ-KJ-23035）; Health Science and Technology Major Project of Hangzhou （Z20220040）

摘要/Abstract

摘要： 【摘要】敏感性头皮是指头皮刺痛、瘙痒、灼热等异常感觉，同时除外其他任何潜在的皮肤疾病。发病机制可能与头皮接触环境中的理化成分（如紫外线、染发剂、洗护用品）、微生物、心理及生理因素、生活方式、脱发疾病等有关。上述各种因素可通过破坏头皮屏障、引起神经末梢高反应性、激活炎症通路等进一步损伤头皮。本文综述敏感性头皮可能机制的研究进展，为进一步探索治疗策略提供思路。

关键词: 头皮皮肤病, 瘙痒症, 炎症, 敏感性头皮, 敏感性皮肤

Abstract: 【Abstract】 Sensitive scalp is characterized by abnormal sensations such as tingling, itching, and burning, excluding any underlying skin diseases. The etiology of sensitive scalp may be related to the exposure to physical and chemical components in the environment （such as ultraviolet rays, hair dyes, and hair care products）, microorganisms, psychological and physiological factors, lifestyle and hair loss diseases. These factors can damage the scalp by destroying the scalp barrier, causing hypersensitivity of nerve endings, activating inflammatory pathways, etc. This review summarizes possible pathogenesis of sensitive scalp, aiming to provide insights for further exploration of treatment strategies.

Key words: Scalp dermatoses, Pruritus, inflammation, Sensitive scalp, Sensitive skin

张蓓蕾宋秀祖. 敏感性头皮的病因与发病机制[J]. 中华皮肤科杂志, 2025,e20240301. doi:10.35541/cjd.20240301

Zhang Beilei, Song Xiuzu. Etiology and pathogenesis of sensitive scalp[J]. Chinese Journal of Dermatology,2025,e20240301. doi:10.35541/cjd.20240301

参考文献 45

［1］	Saint⁃Martory C, Roguedas⁃Contios AM, Sibaud V, et al. Sensitive skin is not limited to the face［J］. Br J Dermatol, 2008,158（1）:130⁃133. doi: 10.1111/j.1365⁃2133.2007.08280.x.
［2］	Misery L, Ständer S, Szepietowski JC, et al. Definition of sensitive skin: an expert position paper from the special interest group on sensitive skin of the international forum for the study of itch［J］. Acta Derm Venereol, 2017,97（1）:4⁃6. doi: 10.2340/00015555⁃2397.
［3］	Ma L, Guichard A, Humbert P, et al. Evaluation of the severity and triggering factors of sensitive scalp in Chinese females［J］. J Cosmet Dermatol, 2016,15（3）:219⁃225. doi: 10.1111/jocd.12203.
［4］	Souza EN, Anzai A, Costa Fechine CO, et al. Sensitive scalp and trichodynia: epidemiology, etiopathogenesis, diagnosis, and management［J］. Skin Appendage Disord, 2023,9（6）:407⁃415. doi: 10.1159/000533795.
［5］	Rebora A. Trichodynia: a review of the literature［J］. Int J Dermatol, 2016,55（4）:382⁃384. doi: 10.1111/ijd.13204.
［6］	Misery L, Sibaud V, Ambronati M, et al. Sensitive scalp: does this condition exist? An epidemiological study［J］. Contact Dermatitis, 2008,58（4）:234⁃238. doi: 10.1111/j.1600⁃0536. 2007.01288.x.
［7］	Burroni AG, Trave I, Herzum A, et al. Sensitive scalp: an epidemiologic study in patients with hair loss［J］. Dermatol Reports, 2022,14（3）:9408. doi: 10.4081/dr.2022.9408.
［8］	Trüeb RM, Starace M, Piraccini BM, et al. Trichodynia revisited［J］. Skin Appendage Disord, 2021,7（6）:449⁃453. doi: 10.1159/000517463.
［9］	Brenaut E, Misery L, Legeas C, et al. Sensitive scalp: a possible association with the use of hair conditioners［J］. Front Med （Lausanne）, 2020,7:596544. doi: 10.3389/fmed.2020.596544.
［10］	Misery L, Myon E, Martin N, et al. Sensitive skin: psychological effects and seasonal changes［J］. J Eur Acad Dermatol Venereol, 2007,21（5）:620⁃628. doi: 10.1111/j.1468⁃3083.2006.02027.x.
［11］	Guichard A, Ma L, Tan Y, et al. What if scalp flora was involved in sensitive scalp onset?［J］. Int J Cosmet Sci, 2016,38（4）:429⁃430. doi: 10.1111/ics.12298.
［12］	Polak⁃Witka K, Rudnicka L, Blume⁃Peytavi U, et al. The role of the microbiome in scalp hair follicle biology and disease［J］. Exp Dermatol, 2020,29（3）:286⁃294. doi: 10.1111/exd.13935.
［13］	Roth RR, James WD. Microbial ecology of the skin［J］. Annu Rev Microbiol, 1988,42:441⁃464. doi: 10.1146/annurev.mi.42. 100188.002301.
［14］	Akbulut TO, Suslu H, Atci T. Is the frequency of seborrheic dermatitis related to climate parameters?［J］. Sisli Etfal Hastan Tip Bul, 2022,56（1）:91⁃95. doi: 10.14744/SEMB.2021.67503.
［15］	Wang Y, Li J, Wu J, et al. Effects of a postbiotic saccharomyces and lactobacillus ferment complex on the scalp microbiome of chinese women with sensitive scalp syndrome［J］. Clin Cosmet Investig Dermatol, 2023,16:2623⁃2635. doi: 10.2147/CCID.S41 5787.
［16］	Ma L, Guichard A, Cheng Y, et al. Sensitive scalp is associated with excessive sebum and perturbed microbiome［J］. J Cosmet Dermatol, 2019,18（3）:922⁃928. doi: 10.1111/jocd.12736.
［17］	Zhang XE, Zheng P, Ye SZ, et al. Microbiome: role in inflammatory skin diseases［J］. J Inflamm Res, 2024,17:1057⁃1082. doi: 10.2147/JIR.S441100.
［18］	Keum HL, Kim H, Kim HJ, et al. Structures of the skin microbiome and mycobiome depending on skin sensitivity［J］. Microorganisms, 2020,8（7）:1032. doi: 10.3390/microorganisms 8071032.
［19］	Meray Y, Gençalp D, Güran M. Putting it all together to understand the role of Malassezia spp. in dandruff etiology［J］. Mycopathologia, 2018,183（6）:893⁃903. doi: 10.1007/s11046⁃018⁃0283⁃4.
［20］	Starace M, Yamagata JP, Cortez de Almeida RF, et al. A practical algorithm for the management of superficial folliculitis of the scalp: 10 years of clinical and dermoscopy experience［J］. Dermatol Pract Concept, 2023,13（3）:e2023131. doi: 10.5826/dpc.1303a131.
［21］	Adalsteinsson JA, Kaushik S, Muzumdar S, et al. An update on the microbiology, immunology and genetics of seborrheic dermatitis［J］. Exp Dermatol, 2020,29（5）:481⁃489. doi: 10.1111/exd.14091.
［22］	Watanabe S, Kano R, Sato H, et al. The effects of Malassezia yeasts on cytokine production by human keratinocytes［J］. J Invest Dermatol, 2001,116（5）:769⁃773. doi: 10.1046/j.1523⁃1747.2001.01321.x.
［23］	Choi JE, Di Nardo A. Skin neurogenic inflammation［J］. Semin Immunopathol, 2018,40（3）:249⁃259. doi: 10.1007/s00281⁃018⁃0675⁃z.
［24］	Buhé V, Vié K, Guéré C, et al. Pathophysiological study of sensitive skin［J］. Acta Derm Venereol, 2016,96（3）:314⁃318. doi: 10.2340/00015555⁃2235.
［25］	Huet F, Misery L. Sensitive skin is a neuropathic disorder［J］. Exp Dermatol, 2019,28（12）:1470⁃1473. doi: 10.1111/exd.13991.
［26］	Misery L. Neuropsychiatric factors in sensitive skin［J］. Clin Dermatol, 2017,35（3）:281⁃284. doi: 10.1016/j.clindermatol.2017. 01.011.
［27］	Pei L, Lin CY, Dai JP, et al. Facial pain induces the alteration of transient receptor potential vanilloid receptor 1 expression in rat trigeminal ganglion［J］. Neurosci Bull, 2007,23（2）:92⁃100. doi: 10.1007/s12264⁃007⁃0013⁃2.
［28］	Honda K, Shinoda M, Furukawa A, et al. TRPA1 contributes to capsaicin⁃induced facial cold hyperalgesia in rats［J］. Eur J Oral Sci, 2014,122（6）:391⁃396. doi: 10.1111/eos.12157.
［29］	Cevikbas F, Wang X, Akiyama T, et al. A sensory neuron⁃expressed IL⁃31 receptor mediates T helper cell⁃dependent itch: involvement of TRPV1 and TRPA1［J］. J Allergy Clin Immunol, 2014,133（2）:448⁃460. doi: 10.1016/j.jaci.2013.10.048.
［30］	Shin SM, Baek EJ, Oh DY, et al. Functional validation of co⁃culture model of human keratinocytes and neuronal cell line for sensitive skin by using transient receptor potential channel vanilloid subfamily member 1 antagonist［J］. Skin Res Technol, 2023,29（1）:e13275. doi: 10.1111/srt.13275.
［31］	Mandadi S, Sokabe T, Shibasaki K, et al. TRPV3 in keratinocytes transmits temperature information to sensory neurons via ATP［J］. Pflugers Arch, 2009,458（6）:1093⁃1102. doi: 10.1007/s00424⁃009⁃0703⁃x.
［32］	Larkin C, Chen W, Szabó IL, et al. Novel insights into the TRPV3⁃mediated itch in atopic dermatitis［J］. J Allergy Clin Immunol, 2021,147（3）:1110⁃1114.e5. doi: 10.1016/j.jaci.2020.09.028.
［33］	Del Duca E, He H, Liu Y, et al. Intrapatient comparison of atopic dermatitis skin transcriptome shows differences between tape⁃strips and biopsies［J］. Allergy, 2024,79（1）:80⁃92. doi: 10.1111/all.15845.
［34］	Gouin O, Lebonvallet N, L'Herondelle K, et al. Self⁃maintenance of neurogenic inflammation contributes to a vicious cycle in skin［J］. Exp Dermatol, 2015,24（10）:723⁃726. doi: 10.1111/exd. 12798.
［35］	Ericson M, Gabrielson A, Worel S, et al. Substance P （SP） in innervated and non⁃innervated blood vessels in the skin of patients with symptomatic scalp［J］. Exp Dermatol, 1999,8（4）:344⁃345.
［36］	Pondeljak N, Lugović⁃Mihić L. Stress⁃induced interaction of skin immune cells, hormones, and neurotransmitters［J］. Clin Ther, 2020,42（5）:757⁃770. doi: 10.1016/j.clinthera.2020.03.008.
［37］	Arck PC, Handjiski B, Peters EM, et al. Stress inhibits hair growth in mice by induction of premature catagen development and deleterious perifollicular inflammatory events via neuropeptide substance P⁃dependent pathways［J］. Am J Pathol, 2003,162（3）:803⁃814. doi: 10.1016/S0002⁃9440（10）63877⁃1.
［38］	Kim YJ, Granstein RD. Roles of calcitonin gene⁃related peptide in the skin, and other physiological and pathophysiological functions［J］. Brain Behav Immun Health, 2021,18:100361. doi: 10.1016/j.bbih.2021.100361.
［39］	Quallo T, Gentry C, Bevan S, et al. Activation of transient receptor potential ankyrin 1 induces CGRP release from spinal cord synaptosomes［J］. Pharmacol Res Perspect, 2015,3（6）:e00191. doi: 10.1002/prp2.191.
［40］	Voss M, Kotrba J, Gaffal E, et al. Mast cells in the skin: defenders of integrity or offenders in inflammation?［J］. Int J Mol Sci, 2021,22（9）:4589. doi: 10.3390/ijms22094589.
［41］	Askin O, Gok AM, Serdaroglu S. Presence of trichodynia symptoms in hair diseases and related factors［J］. Skin Appendage Disord, 2021,7（1）:18⁃20. doi: 10.1159/000511739.
［42］	Mahé YF, Michelet JF, Billoni N, et al. Androgenetic alopecia and microinflammation［J］. Int J Dermatol, 2000,39（8）:576⁃584. doi: 10.1046/j.1365⁃4362.2000.00612.x.
［43］	Kivanç⁃Altunay I, Savaş C, Gökdemir G, et al. The presence of trichodynia in patients with telogen effluvium and androgenetic alopecia［J］. Int J Dermatol, 2003,42（9）:691⁃693. doi: 10.1046/j.1365⁃4362.2003.01847.x.
［44］	Willimann B, Trüeb RM. Hair pain （trichodynia）: frequency and relationship to hair loss and patient gender［J］. Dermatology, 2002,205（4）:374⁃377. doi: 10.1159/000066437.
［45］	Durusoy C, Ozenli Y, Adiguzel A, et al. The role of psychological factors and serum zinc, folate and vitamin B12 levels in the aetiology of trichodynia: a case⁃control study［J］. Clin Exp Dermatol, 2009,34（7）:789⁃792. doi: 10.1111/j.1365⁃2230.2008. 03165.x.

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敏感性头皮的病因与发病机制

Etiology and pathogenesis of sensitive scalp

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